Individual provider Active NPI

Michelle Gibbons

  • Critical Care Medicine Registered Nurse
  • Jersey City, NJ
National Provider Identifier
1346078474
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
26NR24408600 Issued in NJ
Practice address
50 Regent St Apt 514
Jersey City, NJ 07302-6262
Phone
(518) 429-5626
NPI assigned
Jul 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 26NR24408600 NJ Primary

Addresses

Primary practice location

50 Regent St Apt 514
Jersey City, NJ 07302-6262

Mailing address

65 Bergen St
Newark, NJ 07107-3001
Phone (518) 429-5626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260612001074 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 0941772768 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Observation Associates LLCGroup PAC ID 5193137503, 995 clinicians

Practice addresses (Care Compare)

1 Clara Maass Dr
Belleville, NJ 07109-3550
Phone (973) 450-2000

Hospital & facility affiliations

  • Cooperman Barnabas Medical Center Hospital, Livingston, NJ, CCN 310076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NR24408600NJMDCritical Care Medicine Registered Nurse

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1346078474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073001",
            "telephone_number": "518-429-5626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 REGENT ST APT 514",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073026262",
            "telephone_number": "518-429-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NJ",
            "license": "26NR24408600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.